1. Technical Field
This document relates to methods and materials involved in treating bladder cancer patients. This document also relates to methods and materials involved in identifying bladder cancer patients likely or unlikely to respond to treatment (e.g., Bacillus Calmette-Guerin (BCG) therapy).
2. Background Information
Bladder cancer is a significant health problem in the United States, with an estimated 70,530 new cases diagnosed in 2010 and 14,680 estimated deaths. Bladder cancer currently ranks fourth in incidence among all cancers in males and eleventh among cancers in women. In recent decades, the overall incidence of bladder cancer appears to be rising, particularly among patients more than 55 years of age.
Transitional cell carcinoma, the most common pathologic subtype of bladder cancer, is observed in over 90% of tumors. The Tumor-Node-Metastases (TNM) classification (American Joint Committee on Cancer) is a commonly used and accepted staging system for bladder cancer. In this system, bladder cancer tumors have specifically defined characteristics. In particular, non-muscle invasive tumors, including papillary tumors confined to the epithelial mucosa, are termed Ta tumors. In contrast, tumors invading the subepithelial tissue (i.e., lamina propria) are defined as T1 tumors. Tumors with a distinct morphology and a dynamic phenotype are known as carcinoma in situ (Tis). Invasive tumors (T2-4a and T2-4b) are further defined and divided on the basis and extent of their invasive character following histopathologic evaluation.